Co-sleeping with babycan be hazardous

By Larissa Theodore, Calkins Media

Monday

Jul 12, 2010 at 12:01 AM

Parents of newborns have natural instincts to want to protect their little ones by sleeping in close proximity or even the same bed.

But while sleeping with your baby might feel safe at the moment, according to the director of the Child Advocacy Center at Children's Hospital of Pittsburgh, it's a dangerous practice that puts babies at risk.

Dr. Janet Squires said Allegheny County had five sleep-related infant deaths over a five-week period in late May and June. Four of those deaths occurred during the first 20 days of June, she said, adding that the babies were newborns as young as 4 and 6 weeks old. A total of 10 infants in the county have been killed this year, according to Allegheny County Health Department, which tracks annual sleep-related deaths. Last year, there were 20 deaths - nine in adult beds and six on couches, Squires said.

"The truth is the vast majority are sleeping with adults on couches or on beds. Some are suffocations," said Squires, who wouldn't divulge certain details of the deaths.

Bed-sharing among parents and infants has been a topic of discussion - and controversy - for years. The practice is becoming more popular as a way to help moms bond and breast-feed.

Reality television star Kourtney Kardashian recently set off a debate when the 31-year-old admitted on her blog that she sometimes lets her 6-month-old son, Mason, sleep in bed with her. Kardashian wrote that she's been able to bond with her son and considered the risks and took safety measures, such as removing pillows and cushions from her bed.

"I have to be honest: I just love that time," she wrote. "I especially love how when you sleep with your baby, you breathe together on the same pattern. I've been able to bond with Mason so much more."

Hundreds of comments were left within a few hours of her admission.

SAFE SLEEPING ADVOCATES

Squires said sleep-related death is a form of sudden infant death syndrome, or SIDS, but the two are not the same.

SIDS, also known as crib death, has baffled doctors and researchers for years and involves a seemingly healthy, sleeping infant younger than 1 year who dies for no apparent reason.

Every year in Allegheny County, Squires said almost all babies who die in their sleep are not sleeping on their backs, a sleeping position that health experts say has cut the rate of SIDS in half since the early 1990s. Before parents leave the hospital with a newborn in Allegheny County, they are required to watch a video on safe crib sleeping.

"When a child is on their back, in their own crib, or their own bassinet, we almost never see this," Squires said.

But Squires said bed-sharing deaths are preventable, not to mention the risk of injury such as skull fractures from babies rolling off beds. Deaths occur when a baby is wedged between a mattress and a wall, or between a sleeping adult and the couch. A sleeping adult can roll on top of a baby or a pillow can cover an infant's face.

"We believe when an adult falls asleep next to a little bitty baby, there is a potential of the baby not to be able to breathe properly, getting pushed into a couch or a person's body."

For safety reasons, Squires recommends refraining from bed-sharing during a newborn's first six months. She said seeing the look on a mother's face when she realizes she suffocated her own baby is indescribable.

Many advocates for "safe sleeping" stress that babies should always sleep alone in a crib or bassinet. Cribs for Kids, a Pittsburgh-based nonprofit, helps advocate "safe sleeping" in the Pittsburgh area and nationwide by donating cribs.

Last year, state officials in Indiana started airing "shock" public-service announcements warning against co-sleeping. And in Milwaukee, the city's health department is sponsoring an ad campaign that strongly discourages bed-sharing. A statewide child death review also could lead to bed-sharing becoming illegal there.

CULTURAL, MORAL BELIEFS

But for many parents, moral beliefs often dictate where infants sleep. In plenty of cultures, such as Asian societies, bed-sharing is common. In the United States, the practice is mainly prevalent with black, Latino and white Appalachian families, though mothers from various backgrounds share beds with their children, seeing it as a way to bond or ease breastfeeding.

Dr. Jim McKenna, professor of anthropology and director of the mother baby behavioral sleep laboratory at the University of Notre Dame, said the idea that bed-sharing kills babies is "absurd" and believes the practice is an appropriate behavior when done safely.

"People sleep with their babies, not because it kills them, but because it protects them and promotes their survival," McKenna said.

McKenna is a leading academic expert on co-sleeping and has been for decades at the forefront of research on bed-sharing, which he calls "the oldest sleeping arrangement." He has authored several articles, including a March report that appeared in Current Pediatric Review, and has found numerous long-term benefits for children who share beds with parents, psychological as well as physical, such as growing up to be more self-reliant and confident and handling stress well.

"Babies are designed to sleep next to their mothers," said McKenna, who does caution that bed sharing is not for everyone and believes breastfeeding is the key to safe bed-sharing.

Just as there are safe-sleeping rules for babies in cribs - such as removing crib bumpers and stuffed animals - McKenna advises there are safety measures that eliminate risks with bed-sharing, too. This includes not sleeping in anything other than a bed, eliminating crevices or ledges, keeping toddlers or other children out of the bed and avoiding heavy blankets. Parents who smoke, are intoxicated, overweight or heavy sleepers should also avoid bed-sharing, and both parents in the bed have to assume responsibility for the infant's presence.

"In life, there is no 100 percent safety on anything," McKenna said. "The risks are minimal and worth taking for the benefits gained."

Larissa Theodore can be reached online at ltheodore@timesonline.com.

IN BEAVER COUNTY

According to Beaver County Coroner Teri Tatalovich-Rossi, only one infant bed-sharing death has happened in Beaver County since 2006.

The 2007 case involved a Beaver Falls mother who accidentally smothered her 2-month-old daughter when she rolled over on the infant as they slept together in the mother's bed. Early the next morning, the baby's father awoke and found the baby unresponsive in bed, officials with the coroner's office said at the time. In 2005, a 4-month old Freedom infant accidentally suffocated after slipping from a sectional couch, where she was sleeping with her parents and brother, into a plastic storage container, police said.

Beaver County District Attorney Anthony Berosh said his office looks at all the facts behind a baby's death before deciding whether or not charges should be filed.

"Obviously the maternal, or even paternal, instinct when a child is crying is to bring the child with you into the bed," Berosh said.

When there is a sleep-related death, one of the first factors investigators look at is whether the parent was under the influence of alcohol or drugs. They also look at the possible history of child abuse, Berosh said.

Berosh said there was no child abuse or substance abuse involved in the Beaver Falls case. Investigators also found no signs of parental neglect in the Freedom incident. No charges were filed in either case.

IN PENNSYLVANIA

- In 2008, the most recent year for which statistics are available, 85 infants in Pennsylvania died as a result of sudden infant death syndrome (SIDS) or accidental suffocation and strangulation in bed. This was a decrease of 8.6 percent from 2007, when 93 babies reportedly died.

- Of the 2008 deaths, 79 were sleep-related, representing 7 percent of the total deaths reviewed by the state's Child Death Review Teams. About half of the sleep-related deaths involved sleeping with others, while 25 percent were categorized as SIDS deaths of infants younger than 6 months.

Source: Pennsylvania Department of Health

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